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States requesting the waivers need to submit a lengthy application to demonstrate why they’re requesting a waiver from ACA provisions, according to Gretchen Harders, a member of Epstein Becker Green’s employee benefits practice in its New York office.

The application process, she says, includes a detailed 10-year budget plan to show it is deficit neutral. It also requires a timeline, a full analysis and legal authority, and states are also required to hold public hearings on the proposal.